文档介绍：NTproBNP在老年人慢性心力衰竭评估中的临床意义
(作者:___________单位: ___________邮编: ___________)
作者:黄春,吴文伟,徐春平,杨文彦,董开武,陈晓春
【摘要】目的观察≥70岁老年患者心衰不同阶段、心功能分级和左室射血分数(LVEF)对血清氨基末端钠尿肽前体(NTproBNP)水平的影响。方法入选老年住院患者121例。入院即刻评估慢性心衰所处阶段、NYHA心功能分级,超声心动图评估LVEF,电化学发光免疫法测定血清NTproBNP水平。结果(1)慢性心衰A,B,C,D各阶段血清NTproBNP的中位数(Median),,1 ng/L。非参数检验显示各组间有显著差异(P=)。各组间年龄、性别构成无显著差别。左室舒张末期内径(LVEDD)/LVEF随着心衰的发展而增大/降低。(2)血清NTproBNP水平随NYHA心功能分级恶化而增加(P=)。各组间年龄、性别构成无显著差别。(3)LVEF<50%组血清NTproBNP水平显著高于LVEF≥50%组(P=)。结论≥70岁老年患者血清NTproBNP水平与传统的心衰临床评估手段呈现一致的变化,较准确反映慢性心衰的发展进程并随着心衰症状的加重而增加。
【关键词】利钠肽,脑;心力衰竭,充血性;慢性病
ABSTRACT: Objective To investigate the serum concentration of N
amino terminal probrain natriuretic peptide (NTproBNP) in elderly patients (aged 70 years and older) based on the chronic heart failure (CHF) stages, NYHA function classification, and left ventricular ejection fraction (LVEF). Methods CHF stages and NYHA function classification were determined for 121 patients on admission. LVEF and LVEDD were assessed by echocardiography and NTproBNP was assayed by Roche Diagnostics. Results (1) The median NTproBNP level increased with the progress of CHF stages, respectively, stage A ng/L, stage B ng/L, stage C 1 ng/L, and stage D 9 ng/L, P= by nonparametric test. The constitution of age and sex of patients was similar among the groups. With the progress of CHF stages, LVEDD increased and LVEF decreased. (2) NTproBNP concentration was directly paralleled to the severity of HF symptoms based on NYHA function classification, P=. The constitution of age and sex of patients was similar among the groups. LVEF was negatively associated with NYHA function classification. (3) Based on LVEF, NT
proBNP concentration was higher in patients with LVEF<50% than that in those with LVEF≥50%, P=. LVEF was negatively associated with NTproBNP level. Conclusion For patients aged 70 years and older, serum NTproBNP concentration, consistent with th